Individual provider Active NPI

Reina Hisada, M.D.

  • Psychiatry Physician
  • Reidsville, NC
National Provider Identifier
1457615585
Registry record updated Oct 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
1457615585 Issued in NC
Practice address
621 S Main St Ste 200
Reidsville, NC 27320-5034
Phone
(336) 349-4454
NPI assigned
Jul 3, 2012
Last updated
Oct 24, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 182996 NC
Psychiatry Physician 2084P0800X 1457615585 NC Primary

Addresses

Primary practice location

621 S Main St Ste 200
Reidsville, NC 27320-5034

Mailing address

621 S Main St Ste 200
Reidsville, NC 27320-5034
Phone (336) 349-4454

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171021000036 NC Practitioner - Psychiatry 3375842974 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1240 Huffman Mill Rd
Burlington, NC 27215-8700
Phone (336) 538-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1457615585NCMDPsychiatry Physician
182996NCMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
The Moses H. Cone Memorial Hospital Operating Corporation Current Accepting new patients
Alamance Regional Medical Center, Inc. CurrentSince Oct 17, 2022 Accepting new patients
Alamance Regional Medical Center, Inc CurrentSince Oct 17, 2022 Accepting new patients
Moses Cone Affiliated Physicians, Inc Past Accepting new patients

Locations

1236 Huffman Mill Rd
Ste 1500
Burlington, NC 27215
Phone (336) 586-3795

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

1200 N Elm St
Ste 5
Greensboro, NC 27401

509 N Elam Ave
Fl 3
Greensboro, NC 27403
Phone (336) 832-1970

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1341273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508803200000",
    "number": "1457615585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S MAIN ST STE 200",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273205034",
            "telephone_number": "336-349-4454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S MAIN ST STE 200",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273205034",
            "telephone_number": "336-349-4454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HISADA",
        "first_name": "REINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-03",
        "last_updated": "2017-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "182996",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "1457615585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reidsville, NC

Sources for this page

Verify at the official NPI Registry.